The midface is crowded anatomy. The upper jaw, cheekbones, orbital floors and part of the nasal framework all meet within a relatively small area. Shift one of them and the change may reach further than facial appearance — into the bite, nasal airflow, cheek sensation or eye position.
A midface deformity can affect one side or both. One-sided changes usually show up as asymmetry. When both sides are involved, the upper jaw or cheekbone complex may sit too far back, forward, high or low in relation to the rest of the face.
Patients describe it in different ways. “My cheek looks flatter.” “My teeth have not met properly since the accident.” “This side still feels numb.” Occasionally, double vision or a change in eye level becomes the main concern.
The operation is not chosen from that description alone. First comes the harder part: finding which bone — or group of bones — created the change.
The middle third runs roughly from the lower eyelids to the upper teeth. It includes the maxilla, cheekbones, orbital floors and central nasal structures.
A maxillary problem often shows itself through the bite. The upper teeth may sit too far behind the lower teeth or meet them unevenly. Orthodontics can move teeth within bone. It cannot always move the upper jaw itself.
A cheekbone deformity behaves differently. One cheek may lose projection, the orbital rim can sit out of line, and the nerve below the eye may produce altered sensation over the cheek, side of the nose or upper lip.
This is why midface asymmetry correction does not automatically mean operating across the whole region. CT may reveal one displaced cheekbone, an upper-jaw discrepancy or a combined problem.
With an older facial injury, the clue often appears late. The swelling disappears, yet the cheek or bite does not return to its previous position. Meanwhile, the affected bone has already started joining in its new alignment.
That is the territory of midface trauma and reconstruction. Late correction is still possible, but it is not the same job as treating a recent fracture. The healed area may need to be carefully released before the bone can move back towards the planned position.
Other changes develop gradually. One side of the facial skeleton grows differently from the other, or the upper jaw remains underdeveloped. A midfacial deformity of this kind often becomes clearer towards the end of facial growth.
Previous surgery or removal of diseased bone can leave another type of defect. Here, repositioning may not be enough; the missing support itself has to be rebuilt.
The surgeon starts with what has changed. Is the concern mainly the contour? Or has the bite, vision, breathing or sensation changed as well?
The face is viewed from several angles, not just straight ahead. Jaw opening and tooth contact are checked. Eye movement and level may be examined when the orbit is involved. Nasal symptoms can bring an ENT specialist into the plan; visual symptoms may require an ophthalmic assessment.
Bring previous scans and operation notes if they exist. An older image may not replace current CT, yet it can reveal when the position changed.
CT owns the bone story. Dental models show how the teeth meet; photographs show what the overlying tissue does with that skeleton. The three records answer different questions, which is why one cannot simply replace the others.
At UKRMED, the first appointment is with a maxillofacial surgeon in Kyiv. Depending on the findings, the final plan may also need input from an orthodontist, ENT specialist or ophthalmologist.
Two faces can look similarly asymmetric for completely different reasons. One patient has a cheekbone set too far back. Another has adequate bone with less soft-tissue volume above it. Treating both with the same operation would miss the point.
Virtual planning allows the surgeon to move bony segments on a three-dimensional model. For a one-sided deformity, the unaffected side may be mirrored and used as a contour reference.
That mirrored shape is not copied blindly. The bite, orbit, nasal structures and available soft tissue still have a vote.
Cutting guides, patient-specific plates or custom implants can then be made from the digital plan. They are particularly helpful after older trauma, where the original landmarks are no longer tidy.
Midface deformity correction is an umbrella term rather than one operation.
When the upper jaw and bite are the main issues, maxillary deformity correction may involve an osteotomy. The maxilla is moved into the planned position and held with small titanium plates and screws. Access is often through the mouth, leaving no facial skin incision for that part of the operation.
Post-traumatic cheekbone change may call for repositioning or contour reconstruction. A defect in the orbital floor can require a dedicated implant. Missing bone may be replaced with a graft or a patient-specific component.
Bone reaches its planned position during surgery. The tissue above it is slower and less obedient: cheek fullness and facial contour continue changing as swelling fades and the deeper layers adapt. For that reason, an optional soft-tissue correction is sometimes judged later instead of being added automatically to the first operation.
This range of work sits under midface reconstruction.
A substantial reconstruction is usually carried out under general anaesthesia. Hospital stay depends on the extent of surgery and early recovery.
Swelling commonly looks fullest at around 48 hours. It then starts to ease. The final trace, however, can be stubborn, so photographs taken after a few days say very little about the eventual contour.
When the upper jaw has been moved, nasal stuffiness is common at first. The upper lip, gum or cheek may feel numb, tingly or simply unfamiliar. Mouth opening can also be limited. Food begins soft and becomes firmer only as the surgical plan allows.
Oral hygiene takes patience. A small, soft toothbrush is often easier to control around the healing areas. Smoking, meanwhile, makes tissue recovery less predictable and increases surgical risk.
A midface deformity surgery cost cannot be calculated from the word “asymmetry”. Moving the upper jaw is one plan. Rebuilding a cheekbone and orbital floor with a custom implant is another.
The estimate may include several anatomical areas, fixation plates, bone grafting, an individual implant, general anaesthesia and hospital care.
A maxillofacial surgeon consultation at UKRMED costs UAH 1,000. The reconstruction fee is confirmed after CT and digital planning. The service may also appear as midface deformity correction Kyiv or midface reconstruction UKRMED.
For some patients, contour or asymmetry is the main reason for booking. Others also notice an altered bite, troublesome nasal airflow, numbness or a change around the eye. The examination has to separate what is seen from what no longer works as it did before.
It can be a useful starting image, but it is rarely enough for surgical planning. CT provides the three-dimensional position of the maxilla, cheekbones and orbital walls.
Possibly, if the operation changes the upper jaw and bite. Orthodontic preparation aligns the teeth for their future jaw position. An isolated cheekbone deformity does not usually become an orthodontic problem.
Many upper-jaw procedures use an incision inside the mouth. Orbital or cheekbone work may need another approach, often placed near a natural crease. The surgeon explains the planned access before treatment.
Not as soon as the main swelling falls. Bone position is established during surgery, but skin and deeper soft tissue need longer to adapt. A meaningful contour assessment is usually made over months rather than days.
Often it is. Time does add work, though: the bone has united in its altered position, while skin and deeper tissue have learned that contour. Correction may involve releasing the healed segment, filling a residual defect or combining both steps. CT shows which problem remains.
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